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Home My WebLink About8283-zFOig~ NO, 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's South&d, N. Y. Certificate Of Occupancy THIS CERTIFIES that the building located at .,. A~.v.~..h? .s, .L.a..l~.e ........... Street Map No.....~ ....... Block No .... ;z;X~:...Lot No .... XX., .~11.tc.h0gB.e...~.I.,..'/.,. ....... conforms substantially to the Application for Building Permit heretofore filed in this office dated ............ Naut.. ?..., 19.75 pursuant to which Building Permit No...8283~ dated ............ .E.oy... ? .... , 19. ?.[, was issued, and conforms to all of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . .P?.~y.a~.~..o..~.e..ff.a..m~L.~.y...d.~.e.~..~.l~g ....................................... The certificate is issued to .. D.aY.~.~....&..E. 8~.e.y, .~;~g~ll;[.~l ...... .0~e:~ ............... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .t~Ia;f .18t..1.976 ..................... UNDERWRITERS CERTIFICATE No..I~2.8.(~.]~ .... Ap~i],.. 2.~ .] 9~.~ .............. HOUSE NUMBER . ,7.~.0.~. ....... Street .. AlvahJ.:~ ~LaI~e ......................... TOWN OF SOUTHOLD BUILDING DEPAKTMEHT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE wORK AUTHORIZED) 8283 Z Permission is hereby granted to: ..9.~.~.~.,:.~ ~L ..~.L..~.~.~.*.~... ?,..~ ~.~.o. ~~. .......................... i~orth k~d 5outhold bui!c, new one fa~iiv dwel!in~ at premises located at .....~..~...v..a..~..]..s.....~.~..~..e. ............................................................................................ .............................. g~..~.~..o.j~ ....... ~'...:L~..: ................................... pursuant to application dated ....................... ][~V ............ ~. .......... , 19..~..~., and approved by the Building Inspector. Fee $...~.9.t.~g. ......... FOEM NO. $ TOWN OF SOUTHOLD , guildlng Department Town Clerks Office Southold, N. Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in DUPLICATE to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage disposal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installations, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "~re-existing" land uses: 1. Accurate survey.of property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, Occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use $5.00 3. Copy of certificate of occupancy $1.00 .......... New Building ..~(~ ........... Addition ................ Old or Pre-existing Building ................ Vacant Land .............. Location Of Property ~.~.'~.~.`~.....~..z.:.~.~....~..~:.z..~.~/.¥.-..~....~4.:.:.L~;r~..~..:.'~....~. .................. Subdivision ................................................................ Lot No ......... ,.. Block No ............. House No..Z.~ Permit No..~...~.~.~..7~..... Date Of Permit .t!.f~./.~...~....Applicont ~.~...~..~....~,..~P.~.~....~~?. Underwriters Approval .............................................. Planning B~rd Approval ........................................ Request For Tempora~ Ce~ificate ........................................ Fin~ Certificate ....................................... :.. Fee ~bmitted Notary Public ........ ...,,~//~//,/.~,. County Construction on above described building and permit meets oil applicable c(~des ~,nd regulations. Appl,cant .~](~/.~ .... :... .~..q~..)....1~. ,~.~..., ............. (stamp or seal) ') , THE NEW YORK BOARD OF FlEE UNDERWRITERS BUREAU OF ELECTRICITY ~ ak 85 JOHN STREET. NEW YORK, NEW YORK 10038 ''e s6s2z N 280439 o.~,,A rll 28 1976 THIS CERT~IES THA~F~ the above appllcatio- number in the premises of only lite electrical eq~ipn~ent as described below and introduced by tile oppllc~nt named on David Grigonis, w/side Alvah'S Lane, 1500' n/O Route 27A, .,.~,,..,.~.rd,., April 26, 1976 OTHER APPARATUS: 1 G.F.C.I. R V C --~" NO OF NEUTRALS W.B. Ruland, Mattituck, L.I. Lie. 242E GENeRAl D This certificate must not be altered in any manner; return to the office of the Board if incorrect Inspectors may be identified by their credentials. TOWN OF $OUTHOLD r/.,~/-~ _ ~,,,,.~,~ '~,'~ ~,,/-~ ~, ~ ............ ~..~.~.~ ......... L,.,, z~.,d,~ ' ~~~ ........ Disapproved ~/c ........ ~.~ ............... ~, ....................... ~ ............................ ~ ' ~ .......................................... ~ .................... ;~ ........................ ~ .... ...................... ;~;;;~ ................................ APPLICATION F ERMiT ~. This applic~tlo~ m~st be comp~etel~ fille~ in by ~pe~riter o~ in i~k and submitted in triplicate ~o the Inspector, with 3 set~ of pluns, ~ccumte plat plan to ~ale. Fee according ~ schedule. b. Pbt plo~ sbo~lng Ioc~tio~ of lot ~d o~ b~iJ~i~ o~ premises, relationship to ~oi~J~ premises or p~bJic streets areas, and giving ~ detailed description of layout o~prope~ m~St be drawn 6n the dlagr~m which is p~ o~ this application. c. The work covered b~ this application may not be commenced befor~ issuance of Building Permit. d. ~pen ~pprowl of this opplicotio~, ~he B~ildlng Inspector will issue ~ B~ilding Permit ~o the applicant. Such permit shall be kept on the premises availab~e ~er inspection throughout the wor~. e. ~o buil~i~9 shall be occ~pie~ or ~se~ in whole or i~ p~rt ~or ~ny purpose wb~ever ~ntl[ ~ Ce~ifl~te of shall have bee~ 9r~n~ed by ~he B~ddLn9 APPLICATION IS HEREBY ~DE ~o the Building Dep~rtment for the ~ss~ance o~ a Building Permit pursuant B~ildi~g Zone Ordinonce o~ the ToWn o[ Soutbold, Suffol~ Co~nty, ~ew York, and other ~pplJcable Laws, Ordinances or ~e~atio~s, ~or the constr~ctio~ o~b~irdln~s, ~it~o~s or ~tterations~ 0r ~or removal or ~emolition, ~s herein describe~. The applicant ~grees ~o comply wi~ ~[I applicable laws, ordinances, bulldi~g c~e, ho~sing code, ~nd regubdons, ~nd tof~ admit authorized inspectors on premises and in buildings ~or n~essaw in~ections. ,..~....~..:~.:...~:~ .......:~:.~ (~i~tur* of ~li~t, or~m~, if ~ (Address of opplicont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder,x'~ ............ ~,O...b.b%...~..: ............................ , ........................................................... ~ .......... :.: ...................................................... '~ Nameofownerofpremses ~(~t~,~.~..~,...,.~.t~..:..,~.~..,~..,~-.~...,~,......~...,~<.~1~', ..................... . · ........... .. .... ~ If applicant is a corporate, signature of duly authorized,officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumbers License No ..... E,e tr,c,an', L,cense No ......... Other Trade's License No ............................................... 1. Location of land on which proposed work will be done, Mop No.: ..... ; ............. IN. ................. Lot No...c..N ......... : ....... Street and Number r~ ~.~....~.~..~.~ ~ ..~.~.~½.O..~ZX~..~.X).~..., .t..LSI.:~Z: ....... ..... ~ ' df 0 Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exlsiting use and occupancy ................................................ ~-,-':~,.~: ..... '"T ...................... ..... : ;.'.~..~..x3.q~:~.~....T.:.~..~..~.,~..S.Cx~ ... ............................................. b. Intended use and occupancy\ 3. Nature of work (check which applicable): New Building. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior. .................... Other Work ................................................ . .... 4. Estimated Cost .... .q.g'~.t.~.. ............................... Fee (~ '~?'~-'~ (Description) (to be paid on filing this application) 5, If dwelling, number of dwelling units .......... I ................. Number of dwelling units on each floor ......... k ................. If garage, number of cars ...... ~..C~fi~.-f~ ................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ N~mber of Stories ................................ 8. Dimensions of entire NumberneW constructiOn:of StoriesFr°n~...~"~ ...................... Rear ....~.~ ............... Depth/. _ _, ''''~ ................ Height .................... ...... ........................................................................ ~ ~.~.~.:..,~.~'..~.. 9. Size of lot: Front ........... ........................ ....... ............... Depth .~..~..~.¢~.~..).. 10. Date of Purchase ........................................................ Name of Former Owner .~.~~.~.~ ~ 1. Zone or use district Jn which premises are situated ..................................................................................................... t2. D6e~ proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will Jot be regraded . ...... ~.~ ........... Will excess fill be removed from premises: ( ) Yes ( 14. Name of Owner of premises ~.~.;X ~.~qX~l~ddress ..h~W~k~.~ .... Phone No ...................... Nome of Architect .............................................................. Address ................................ Phone N~ ...................... Name of Contractor .-~..~'.t.~bi.~.M5 ........................ Address .~eLJZ~P.b.~...~Phone No. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~r ~t~ t¢¢ ~ ~a/ ~ ~ COUNTY OF ..... ~.~..[I.k...~ ~....~¢~.....~ ...... ~C~.~.~ ................... b~ d~y ~worn, deposes ~d (Name of individual signing contrac0 above gamed. He is the .............................................. P..,~.~..~.C. ............................................................................................................. (Contractor, agent, corporate officer, etc.) of soid owner or owners, a~d is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fo~h in the application filed therewith. Sworn to.before me this -- -- ........ o, ................... , / ..................... ..... ................. {Sl~noturo o{ oBp~nt) TU, CULTIVATED A~E/k 4~o.oo N.Y. .t / u~AY 1 8 1976 .. ~. ~. ~ 3S o The sewage disposal and water sunply facilities for this location have been totn 9~ c~2t~~ent~~ ~'and~ fo~ Chief' of General ~gin~erim~ Se~lcea ~ ~ B2'iO" ~'. 46~,~ F FL ~ ~.¥~TlOlq / ,"-' cone. ~ APPROVED AS NOTF_..~ NOTIFy BUILDING DEPARTMENT 765-2660 9AM TO 4PM FOR REQLlri~_ ED iNSPECTIONS: 1 BEFORE BACKFILLING FOUNDA-. TION OP, START FRAMING C -7405 T - 4 I0SHEET - I PLAN '- 2 TOTAL - 4 FZNIZ.' I~,L ~ LOOIE FLA Eg- Id' :,t,, M I L-¥N ~F~A ' ;¢2 DI HIkJ~ ¢~ I&LI* DIVIN~] IE'OoM 14.'_0II ~ ~,LD~ LIM~ ES~L I~ ooF- KITE'HEM EAI~'f'. F-..L.¢V,~,,'FIDN t - 4 I_0/ SHEET- 2 PLAN I~ 2 TOTAL- 4 ~ L~,UH FI L-L-I H 17 LD" "r yp leAL C~I~ N lC. C:: . d." E~LOx¥ H II,ISUL6,~IO H T-~IO PLAN - I SHEET -$ TOTA k - 4 E NO~Jl ~ouN~, /~,L 4-" FO q L ~J' 17L3" "P L ~. N P£1'~, II. L I< PLAN - T-4 TOTAL - 4